Fetal cerebral hemorrhage caused by vitamin K deficiency after complicated bariatric surgery

BACKGROUND: Restrictive bariatric surgery decreases obesity-related morbidity and mortality. With the widespread use of these interventions, an increasing number of women who have undergone bariatric surgery become pregnant. CASE: A women, pregnant 2 years after laparoscopic gastric banding, presented with prolonged vomiting due to slippage of the gastic band resulting in gastric outlet obstruction. Parenteral feeding was initiated for 3 weeks until the patient was delivered because of a nonreassuring fetal heart rate pattern. A postnatal diagnosis of an extensive intracranial fetal hemorrhage due to maternal vitamin K deficiency was made. CONCLUSION: Although restrictive bariatric surgery is generally considered safe, we want to warn of possible severely adverse outcomes related to the intervention. In case of food intolerance, early vitamin substitution is indicated.